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Social Science and Medicine. 1992 Apr; 34(8):837-42.Researchers analyzed data from 117 countries taken from 2 1988 World Bank publications to determine the relative importance of health care resources in predicting infant mortality within developed, developing and underdeveloped countries. Overall the variance of infant mortality, accounted by only socioeconomic resources, was 32.8% in underdeveloped (p<.01), 34.3% in developing countries (p<.05), and 60.6% in developed countries (p<.1). Further almost all these variables had constant directions of relationship with infant mortality across the 3 subgroups. For example, GNP and education were always negatively associated with infant mortality and urbanization and water were always positively associated with infant mortality. In fact, water had the greatest effect in developing countries and the smallest in underdeveloped countries. Further education was the only statistically significant socioeconomic variable in underdeveloped and developing countries (p<.05). Energy was inversely related with infant mortality in underdeveloped and developing countries, but positively related with it in industrialized countries. Further calorie had an inverse relationship with infant mortality in underdeveloped countries, but a positive relationship in developing and developed countries. In terms of health resources, the variance of infant mortality was not significant and was only an additional 8.6% of that above the variance explained by socioeconomic resources in underdeveloped countries, 5.6% in developing countries, and 3.3% in industrialized countries. Yet the association between inhabitants/ physician was consistent across all subgroups. Further the physician's role in reducing infant mortality was greatest in developing countries. The other 2 health care variables were inhabitants/nurse and inhabitants/hospital bed. In addition, as life expectancy increased, the effects of health care resources on infant mortality fell.
[Unpublished] 1990. Presented at the Annual Meeting of the Population Association of America, Toronto, Canada, May 3-5, 1990. , 28 p.Household survey data from Brazil, matched with information collected at the municipio (county) level, are used to examine the relation between parental characteristics (primarily education), community infrastructure and services, and child height. Data are drawn from 2 sources: Informacoes Basicas Municipais (1974) is a periodic survey of 4000 municipios on infrastructure, health and education services. Estudo Nacional da Despesa Familiar (1974-75) is a household survey covering 37,000 children under age 8 on income, expenditure, anthropometry and socio-demographic characteristics. Local food price indices were derived from these data. Child height is significantly affected by local infrastructure, particularly modern sewerage and piped water in urban areas and electricity in rural settings. These effects are stronger for children over 2, those of better educated mothers, and those in households spending more. Higher prices for dairy products and sugar are linked to lower urban child height, and higher fish prices to lower rural child height, significantly for children of illiterate mothers. Higher prices for meat and rice are associated with taller height, possible because men usually eat these foods. Mothers with elementary schooling can counteract the effects of food prices on child height. Number of teachers is positively related to height in rural children. Numbers of nurses and of hospital beds is associated with shorter children, suggesting that large hospitals locate in poor urban areas. This study has succeeded in identifying some public investments that affect child health.